Oophorectomy-Corrected Ovarian Cancer Incidence, Survival, and Mortality by Subtype, Race, Ethnicity

Most ovarian cancers are detected at advanced stages, with poor outcomes. Ovarian cancer is heterogeneous; the most common subtype, serous ovarian carcinoma, may originate outside of the ovaries. To inform etiologic heterogeneity, prevention, and treatment of ovarian cancer, we conducted the first evaluation of oophorectomy-corrected incidence and mortality trends of ovarian, fallopian tube, and peritoneal cancers.

Ovarian cancer incidence, survival, and incidence-based mortality overall and by subtype were analyzed using the U.S. Surveillance, Epidemiology, and End Results (SEER)-22 and SEER17 databases including cases from 2000 to 2019, with oophorectomy correction based on data from the National Health and Nutrition Examination Survey (NHANES). Rates were age adjusted per 100,000 person-years; annual percent changes in rates were calculated.

Age-adjusted prevalence of oophorectomy changed minimally between 2000 and 2019 and was highest among Non-Hispanic White women. Oophorectomy-correction increased ovarian cancer incidence rates by 23% on average. Ovarian cancer incidence decreased by 2% between 2000 and 2019, with a stronger reduction observed in recent years. Fallopian tube cancer incidence increased by 7% from 2000 to 2019. Relative 5-year survival was lowest among Non-Hispanic Black women even after accounting for histotype and stage. Ovarian cancer mortality decreased by 1.8% between 2000 and 2019. Serous carcinomas contributed to 68% of ovarian cancer cases, but 83% of all ovarian cancer deaths.

The reasons for decreasing ovarian cancer incidence are not understood. There is evidence for some reclassification of primary ovarian to primary fallopian tube cancers. Low survival rates in Non-Hispanic Black women point to disparities along the continuum of care.